Clinical Features of Pingueculitis Revealed by Anterior Segment Optical Coherence Tomography Findings.

PURPOSE: To investigate clinical features and treatment outcomes of pingueculitis with morphological assessments using anterior segment optical coherence tomography (AS-OCT). METHODS: In this retrospective observational study, we examined 22 eyes of 22 patients with pingueculitis. All patients were treated with the same 2-week course of prednisolone acetate 1% drops four times per day. The clinical parameters evaluated were surface dimensions determined by slitlamp biomicroscopy, cross-sectional dimensions determined by AS-OCT, and symptom scores determined by patient surveys. Pretreatment and 1-month posttreatment values were compared with Wilcoxon signed-rank tests. Patients were followed up to 1 year after treatment. RESULTS: Twenty-two eyes from 22 patients (4 men and 18 women) with an average age of 37.7±8.8 (range, 27-57) years and an average duration of symptoms of 22 (range, 5-60) days were included. The average follow-up period was 14.7±0.8 (range, 12-22) months. Mean pretreatment horizontal length, vertical length, conjunctival thickness, and cross-sectional area were 2.4±0.69 mm, 2.0±0.6 mm, 1.82±0.60 µm, and 5.14±2.05 mm, respectively. Mean posttreatment horizontal length, vertical length, conjunctival thickness, and area were 1.93±0.5 mm, 1.52±0.6 mm, 1.03±0.46 µm, and 2.33±0.83 mm, respectively. Mean pretreatment and posttreatment dry eye symptom scores were 3.27±0.77 and 1.13±0.38, respectively. The median pretreatment and posttreatment changes were statistically significant by Wilcoxon signed-rank tests for horizontal length (P<0.001), vertical length (P<0.001), conjunctival thickness (P=0.003), cross-sectional area (P=0.003), and dry eye symptom scores (P<0.001). CONCLUSION: Anterior segment optical coherence tomography allows the quantification of differences in the pingueculitis measurements before and after treatment. In this retrospective study, a short course of topical steroids effectively treated the inflammation in a sustained manner. Anterior segment optical coherence tomography demonstrated significant reduction in the thickness and cross-sectional area of the pinguecula and a conversion back to a homogeneous conjunctival stroma.

[Intra-lesional injection of betamethasone for the treatment of symptomatic pinguecula]. / Infiltración intralesional de betametasona como tratamiento de la pinguecula sintomática.

CLINICAL CASES: The pinguecula is a degenerative lesion which is usually asymptomatic, except when it is associated with an inflammatory reaction. We present 2 clinical cases of patients that had symptomatic pinguecula, in which intra-lesional betamethasone in depot form was used as treatment, obtaining a significant clinical improvement. DISCUSSION: The administration of intra-lesional betamethasone in depot form may be a good alternative for the treatment of the symptomatic pinguecula.